Data from the Framingham Offspring Study show that hypertension, obesity and high triglyceride levels (odds ratios 1.76, 1.71 and 1.43, respectively) are all predictive of chronic kidney disease (CKD) development 30 years before diagnosis. After diagnosis of CKD, intensive risk factor management is generally recommended. This study suggests that early risk factor identification and subsequent management might enable CKD to be avoided later in life.